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DSF (11-0404) + RR (08488)78186 Main St 11-0404 08488 TAt!t4 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT 4(brf,. A SOI - 1845 - 651. 7".1 Date: 4/20/11 Application Number: 11-00000404 Owner: Property Address: . 78186 MAIN ST nnvn =. _.t<T O Lk U1 U/ %TA APN: 770-123-004- - P.O. Bo)L 1504 Application description: DEMO - SINGLE FAMILY (A Q11oNrA C.A q 22,47 Property Zoning: VILLAGE COMMERCIAL .Application valuation: 0 Contractor: nCITY Applicant: Architect or Engineer: EMERY.LANDCLEARING/GRADNP.O. BOX 1009 THERMAL, CA 92274 1.2011 (760)391-5840 Lic. No.*: 600283 D.P. --------------------------------- LIC SED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that 1 licensed and ovisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury ane of the following declarations: - Section 7000) of Division 3 of the Business a Profe ion s C e, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License C ss: Q21 a No.: 600283 • for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Date: / I ntractor:. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workerscompensation - OWNER -BUILDER DECLA ON insurance carrier and policy number are: I hereby affirm under penalty of perjury that 1 am exempt from the Contra 's State License Law for'the Carrier GRANITE STATE Policy Number WC3528515 following reason (Sec. 7031.5; Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performa g of the wor ' which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so a t become ubje to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should a ome subj t the workers' compensation provisions of Section . License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the bor C all forthwith mply with those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by - any applicant for a permit'subjects the applicant to a civil' penalty of not more than five hundred dollars ($500).: Date pplicant: 1—) 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FA URE TO SECURE WORKERS' COMPENSATION CO AGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS (5100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are, not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). APPLICANT ACKNOWLEDGEMENT (_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety fora permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of.this application, (_) I am'exempt under Sec. ', B.&P.C. for this reason "' the owner, and the applicant, each.agrees to, and shall defend, indemnify and hold harmless the City Date- Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of.the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above formation isct. I agree to comply with all city and count ordinances and state laws relating to build' g c truction, a hereby authorize representatives of this county o en r upon a above-mentioned propert or ' pection poses. Dat ignature (Applicant or Agent): Application Number 11-00000404 Permit DEMO PERMIT Additional desc . Permit -Fee' 45.00 Plan Check Fee .00 „ Issue Date' Valuation ,0 Expiration'Date 10/17/11 • Qty, Unit Charge Per Extension BASE FEE 45.00 Special. Notes and Comments L. DEMO TO BARE GROUND•SINGLE FAMILY DWELLING, INCLUDING REMOVAL OF SEPTIC SYSTEM, 2010 CODES., Fee summary. Charged Paid ---------- Credited Due . . ----------------- Permit Fee Total 45.00 .00 .0.0 45..00 Plan.Check Total .00 :00 .00 .00 Grand Total 45.00 .00 .00. 45.00 LQPERMIT - 'ben o CITY OF LA QUINTA - PUBLIC WORKS DEPARTMENT GREEN SHEET PUBLIC WORKS CLEARANCE FOR RELEASE OF BUILDING PERMIT t Form updated & effective 9/25/2009 Green Sheet approvals are forwarded to the Buildinq & Safety Department directly by Public Works. Please DO NOT submit the Green Sheet (Public Works Clearance) Packet to the Public Works Department until ALL requirements listed below are complete. Incomplete applications or applications which cannot be processed will be returned to applicant. Date: 4 /2t/ 11 Developer: EMERY LANDCLEARING AND GRADING, INC. FOR CITY OF LA QUINTA Tract No.: Tract Name: Address(s): 78-186 MAIN STREET Lot No.(s): Phone Number: ( 760 ) 391-5840 The following are the requirements for Public Works Clearance to authorize issuance of a building permit from the Building & Safety Department: .. 2. 3. 4. 6. 7. RECEIVED APR 19 2011 Attach Pad Elevation Certificates in compliance with the approved design ele®aion r1S d (i imum allowable deviation of +/- 0.1 foot). Pad Elevation Certificates must be current (within 6 months of current date). If a precise grading plan creates the pad for approval, please withhold green sheet submittal until a Pad Elevation Certificate can be provided. Attach geotechnical certification of grading plan compliance including compaction reports from a licensed Soils Engineer. Recently rough graded residential developments which have a previously approved geotechnical certification are exempt from this requirement. Attach recorded final map or title information/grant deed showing proposed building locations are legal lots. Complete the attached <1 acre per lot or infill project Fugitive Dust Control project information form, PM10 plan & agreement or provide alternative & valid City approved PM10 plan set reference number or hard copy plan. PM10 plans for commercial & residential developments (beyond 1 lot) are submitted separately with grading plans & are subject to additional requirements. A current PM10 certification number is required. Attach a copy of the rough or precise grading plan to the Public Works Department showing building location(s) for pad elevation verification. AO flood zone developments will require an approved flood plain development plan. Attach supporting documentation for wall plan, monument sign, grease trap or special facility installations. Complete and sign the attached water quality management plan (WQMP) exemption form, if applicable. PW approved building construction projects require either a WQMP or a completed WQMP exemption form. Approved maps/plans may be viewed at the following link: http://www.la-guinta.org/PlanCheck/m search.aspx I have reviewed and confirmed the requirements listed above as presented and find the improvements to be sufficiently complete for construction of the proposed buildings/structures/walls/signs on the subject lot(s). Pursuant to my findings, the above project may be released for building permit issuance. This section completed by City staff. Recommended by: Date: T / -LO/ Public Works Distribution: ( Green Sheet to Building & Safety ( ) Green Sheet to Planning Department Declined for approval for reason(s) as follow(s), please correct and resubmit: TACheddists - Forms & ApplicationsWonns & Applications\GREEN SHEET rover & PM10 less than 1 Acre Revised 9.25-09.doc IW City of La Quinta - PM10 Fugitive Dust Control Project Information Construction Phase PM10 Aareement (<1 acre/lot or Infill Proiectl Project Information Project Contractor: EMERY LANDCLEARING AND GRADING, INC. Project Phase (check one) Construction RV/ Demolition Project Name: Project Tract/Lot Numbers: Project Street Address: 78-186 MAIN STREET Total Acres in Active <1 Construction (<1 acre per Lot): ruc SFT Anticipated Start Date: 4 / 2# / 11 Anticipated Completion Date: 4 / 27 / 11 PM10 Contact Information Please note: Dust control is required 24 hours a day, 7 days a week, regardless of construction status. Person listed below is responsible for dust control during business and non -business hours. Name: JAMES C. EMERY Title: PRESIDENT Company Name: EMERY LANDCLEARING AND GRADING, INC. Mailing Address: P.O. BOX 1009 City, State, ZIP Code: THERMAL, CA 92274 Primary Phone #: 760/391-5840 r Fax #: 760/391-5839 24 Hour Emergency Phone#: 760/391-5840 Cell Phone #: 760/774-9493 Email Address: EMERYLCRECYCLING@AOL.COM PM10 Certificate #: I CV10-11-1345 The above stated property owner (or authorized representative): Shall act as his/her acknowledgement of dust control requirements and their enforceability, pursuant to SCAQMD Rules 403,4403.1, 401, 402, 201, 203 and PERP; Shall constitute an Agreement to comply with all project conditions as identified in the approved dust control plan. ❖ Acknowledges that dust control is required twenty-four (24) hours a day, seven (7) days a week, throughout the period of project performance, regardless of project size or status; ❖ Shall ensure that each and every contractor, subcontractor and all other persons associated with the project shall be in continuous compliance with all requirements of the approved dust control plan; ❖ Shall take all necessary precautions to minimize dust, even if additional measures beyond those listed in the dust control plan are necessary; Shall authorize representatives of City/County to enter the property for inspection and/or abatement purposes; Shall hold ha I the C /Cou ty and its representatives from liability for any actions related to this dust control plan or an; Ci County in abatement activities. ,19r2 ji Signature of operty Own or Authori d Representative Date TAChecklists - Forms & ApplicationslForms & Applications\GREEN SHEET cover 8 PM10 less than 1 Acre Revised 9-25-09.doc EMERGEr OF I�9 Y Return check to requestor D. Aaker or G. Butler/K. Hemel is Name / Title of person resting check T. Hartung Department individual is associated with: r . Building & Safety CJEST F6' RD Mail check Date check required by: Friday, April 15, 2011 :ITEC CHECK Check payable to: MASTERS ENVIRONMENTAL. Amount:$ 500.00 Ka—m--e) en or o. 44719 Alexandria Val8e Account Number: 401-1845-551.74-01 (Address) Indio; CA 92201 Project Number: RDA demolition project - asoestos inspection se c s Check requested for asbestos in.spection,•sampling, and -report services following i completion of project per attached invoice. Describe emergency in detail: Check requested before next warrant run cycle since project has been completed. r.$ f,s } tk,rykii., '4 14 * (Department r ♦: �z ='F. . iii c ... �! � ' � '" � � a �,n `:" � A a .n � j t Y . � �� (Finance Director's Approval) Obio oLa Quints CHECK NO. 91546 MASTERS.ENVIRONMENTAL 5406 04/15/2011 DATE INVOICE` ACCOUNT DESCRIPTION AMOUNT - 04/13/11 1733 401-1845-551-74.01 RDA DEMO—MA•IN 500.00 500.00 DOCUMENT HAS A COLOREDBACKGROUND.ON 4 WELLS FARGO BANK t•24/t2t0 IBI Qc1. 546 . CHECK NO. c7 s P.O. BOX 1504 w 78-495 CALLE TAMPICO LA QUINTA, CA 92253 DATE AMOUNT 04/15/2011 $******500.00 NO(760) 777-7150 PAY '. 5 • • • • TO ( THE MASTERS ENVIRONMENTAL AUTHORIZEo NAT E ORDER` 44719 ALEXANDRIA VALE INDIO CA 92201 OF • _ _ AUTHORIZEP SIGNATURE 1119 Ls I, Gul 1e1,21,000248: 4 1, 59 28 248.211' INVOICE 1733 MASTERS ENVIRONMENTAL Division of Master Search Inc. 44719 Alexandria Vale, Indio, CA 92201 (888)485-2900 gmasters@sonic.net To:. City of La Quinta 'ri`. ., c ; ►n#, P. O. Box 1504 ?:Y La Quinta, CA 92247 Attention: Tom Hartung i;"' V " $ S SS ,1 }-0 ... KE A- es} • , T' ; 1 T. ') , t ( 00 0o Sc, ` i t , 1: - For: ASBESTOS SERVICES Date April 13, 2011 For asbestos inspection, sampling, and.report for structure at $ 300.00 78186 Main St., . La Quinta, CA 10 samples of suspected asbestos containing materials for laboratory analysis by Polarized Light Microscopy @ $20/sample 200.00 $ 500.00 Terms: Due and payable on receipt Total: $ 500.00 MASTERS ASBESTOS SURVEY DATE OF SURVEY: April 8, 2011 LOCATION: 78-186 Main St. La Quinta, CA BY: Gregory Masters California Certified Asbestos Consultant # 03-3365 Masters Environmental 44719 Alexandria Vale Indio, CA 92201 760-200-2900 Survey authorized by: Tom Hartung, City of La Quinta Methods: All materials in the structure that were suspected of containing asbestos were sampled according to specified protocols. Samples were sent to a NAVLAP accredited laboratory, Patriot Laboratories, Garden Grove, CA — Lab code 200358-0. They were analyzed by Polarized Light Microscopy according to Bulk Analysis Protocol EPA 600/R-93/116. The laboratory report is attached to this message for your inspection Site: This structure is a single family residence. The scope of work is to determine the asbestos content of the roofing, the drywall; the taping compound, the stucco, and the window putty. p. 2 Sampling Table: Sample Location Description Friable Quantity Condition Asbestos 001',Kitchen 12x12 floor tile NF 80 sq.ft Good ND 002 Kitchen Wallbd & TC F 3000 sq.ft Good ND 003 Living Rm F Good ND 004 Bedroom F Good ND r 005 ` 'Windows Puttyr NF ' 120: Im, ft :. Goodti . 3%a C "Ns 006 NF Good . ND ti G`ood; 001 002 003Storage ' Bath Be 004 ---"L 005 ------- 006--_ 007 008 n Living Rm 009 010 Sampling Locations RESULTS: Of all the materials tested, only the window puttyaestedpgsitie:for:asbestos. Half of the windows are not puttied, but the other half has 3% Chrysotile asbestos. The figure of 120.1ineal feet is very loose, and must be•refined for bidding purposes. No guarantees are offered or implied. We appreciate the opportunity to serve your asbestos.needs, and look forward to working with you again.- ESI-08 gain:ES os W. No. 03-3365 cAUFORN P , Masters Environmental 760-200-2900 44719 Alexandria Vale 760-200-2901 FAX Indio, CA 92201 2masters(a,sonic.net p. 4 Certificate of Analysis IT PLM Asbestos Identification Td: 7 f 4.699.8900 Free- 888.743-0998 Fax: 7 14,899.709@ flip',1/v" v.patrlodabxoro PAM? 7271 Garden Grove Siva_, Shite A Garden Grove, CA 92841 Patriot Environmental Laboratory :Services, Inc, Masters Environmental 1 Report Number: 412145 44719 Alexandria Vale Project Number: 1733 Indio, CA 92201 Project Name: La Quinta Project Location:78-186 Main St. La Quinta, CA Date Collected: 4/8/2011 Collected By:. Date Received: 4/9/2011 Claim Number: Date Analyzed: 4/9/2011 PO Number: Date Reported: 4/11/2011 NumberofSamples: 10 Lab/Client ID/Layer Location Material Description Color Composition (%) 412145-001 Kitchen 12x l2 Floor Tile Beige 80% Carbonate 001 20% Vinyl Binder Total Asbestos None Detected 412145-002 75% Minerals Kitchen Wallboard and Beige White Grey 002 Taping Compound 20% Carbonate 5%Paint Total Asbestos None Detected 412145-003 75% Minerals Living Room Wallboard and f Beige White Grey 003 Taping Compound 20% Carbonate 5% Paint Total Asbestos None Detected , 412145-004 Bedroom Wallboard and Green Pink Green 75% Minerals - 004 - Taping Compound 20% Carbonate 5% Paint Total Asbestos None Detected 412145-005 Windows Putty Red White 93% Carbonate 005 4% Paint. . Chrysotile 3 % Total Asbestos 3 Pagel of 3 Certificate of Analysis ' PLM Asbestos Identification TO: 714.a99-0900 Free: 886,743.:0998 Fax: 71-3,899.7018 " . hit 1r'wo+gw.p;ttrit5ti i ,cem Patriot Environmental Laboratory Services, Inc. .7271 Garden Grove 81vd:,-5uitc A Garden Grove, CA 92841 Masters Environmental Report Number: 412145. 44719 Alexandria Vale Project Number: 1733 Indio, CA 92201 Project Name: La Quinta Project Location: 78-186 Main St. '= La Quinta, CA 1 Date Collected: 4/8/2011 Collected By: Date Received: 4/9/2011 Claim Number: Date Analyzed: 4/9/2011 PO Number Date Reported: 4/11/2011 Number of Samples: 10 Lab/Client ID/Layer Location Material Description Color Composition (%) 412145-006 Windows Putty Red White 96%Carbonate 006 4% Paint Total Asbestos None Detected 412145-007 Windows 93% Carbonate Putty Red White 007 4%. Paint ' Chrysotile 3 Total Asbestos 3 412145-008 Stucco 85%.Minerals Stucco Grey Beige 008 12% Carbonate ' 3% Paint Total Asbestos None Detected' 412145-009 Stucco 85% Minerals Stucco Grey White Beige 009 12% Carbonate 3% Paint Total Asbestos None Detected 412145-010 Roof 65% Tar BL Rolled Roofing Black White 010 .. 15% Glass Fibers 20% Minerals Total Asbestos None Detected Page 2 of 3 Certificate of Analysis PLM Asbestos Identification reg: 714.699-8900 Frcct 888343.0998 Fax: '714,899..7098 ht1p;fW%.1Wp 0Otl8b.cam Patriot Environmental Laboratory Services, Inc. 77.71 Garden Grove Blvd., Suite A Garden Grave, CA 92841 Masters Environmental Report Number: 412145 44719 Alexandria Vale Project Number: 1733 Indio, CA 92201 Project Name: La Quinta Project Location: 78-186 Main St. La Quinta,.CA Date Collected: 4/8/2011 Collected By: Date Received: 4/9/20111 Claim Number - Date Analyzed: 4/9/2011 PO Number: Date Reported: 4/1 1/201 1 Number of Samples: .10 Lab/Client ID/Layer Location Material Description Color Composition (%) Bulk sample(s) submitted was (were) analyzed in accordance with the procedure outlined in the US Federal Register 40 CFR 763, Subpart F, Appendix A; EPA -600/R-93/116 (Method for Determination of Asbestos in Building Materials), and EPA -600/M4-82-020 (US EPA Interim Method for the Determination of Asbestos in Bulk Insulation Samples).Samples were. analyzed using Calibrated Visual Estimations (CVES); therefore, results may not be reliable for samples of low asbestos concentration levels.; Samples of wall systems containing discrete and separable layers are analyzed separately and reported as composite unless specifically requested by the customer to report analytical results for individual layers. This report applies only to the items tested. Results are representative of the samples submitted and may not represent the entire material from which the samples were collected.. "None Detected" means that no asbestos was observed in the sample. <I %" (less than one percent) means that asbestos was observed in the sample but the concentration is below the quantifiable level of I %. Lyn Terry - Analyst [an Reyes - Approved By This report was issued by.a NIST/NVLAP (Lab Code 200358-0) and CADOHS- ELAP (Cert. No' 2540) accredited laboratory and may not be reproduced without the expressed written consent of Patriot Environmental Laboratory Services, Inc. This report may not be used to - claim product certification, approval or endorsement by NIST, NVLAP, ELAP or any government agency. Page 3 of 3 `i , 1 :qui Client : M7 Client Address: Client Contact: Contact Phone: oiitdct Ceil: Contact Fax: Special Instructio Analytsis Re PCAA (fibercount) PLM (bulk asbestos) PATRIOT ENVIRONMENTAL LABORATORY SVCS, INC. CHAIN OF CUSTODY Lab use only www.patrlotlab.com Report Number: f S '►t t%r rolloff l Pro'ect #: / 7 3 f 4' 1- na('rt Vice Pro'ect Name, L Q4t w aZ2 a/ Location:7$•I$!Sam le Collection Date:~ 4 Preservative: n Au"Ehurized B 4 d a Li O --Zc1)C_) — PO#: _ Claim #: ueste NIOSH 7400A PPA 600/R-93/116 CARB 435 Point Count 400 Point Count 1000 Gravimetric Reduction 0 ( i9e of {Turnaround Time Rush (Same Da) Other 24HR (specify): 46HR 0 72HR 0 Vole :-STLGCAL WET requires a minimum of 52 hrs turnaround -TCLP requires a minimum of 22 hrs turnaround -Cultures require 5.7 days turnaround elin uished B ( lint) h r ' 03 •3i65 (si n) 02 v Elyecaived t3lr: (print) ished B (si n) (date ( Tint (si n)(date (print) :ce)ved By: ;linquished B (print) (sign) (date) (sign) :ceived By: (print) (date} (sign) (date) t- c/s Bin # City of La Quinta Building 8r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # O , I ` Project Address: — p ' %. Owner's Name: C t (G j 7 )161 A. P. Number: Address: Legal Description: Contractor: \ 1.S t t'I G City, ST, Zip: C, ` ::^ ' ''»" • Telephone::•:.3s::s3A:'5 %^;.i Address: t b Project Description: City, ST, Zip: I/11 &0 Telephone: q&01.391— • 1 I O Jif h;: ` `,?'•' .. /.»%ljf>t :j'.i.;::};i State Lic. # : 1,96 6 3 Arch., Engr., Designer: City Lic. # Address: City., ST, Zip: Telephone:'<': tw;,`v„<:;,<Construction State Lic. #::,' ": :•i: Vii: `RL'i{iiiv'n':k is i:Ql: v'.v;:;: ;:.}v: 'at.. ..:kif' }': `'i :::vi:vjirrtii:jL •:'.''.iit.•. Type: O Occupancy:' Project type circle one New Add'n Alter Repair Demo Name of Contact Person: Lori Sq. Ft.: SOD # Stories: # Units: Telephone # of Contact Person:. j O ql, Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount - Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2”" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 'A Review, ready for correctionsrssue Developer Impact Fee. Planning Approval Called Contact Person A:I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees P O Box 1504 78-495 CALLE 'TAMPICO LA QUINTA, CALIFORNIA 92253 August 26, 1999 Mr. Ron Skinner E. L. Yeager Construction P.O. Box 87 Riverside, California 92502 SUBJECT: MINOR USE PERMIT 997163 . . (760).777-7000 (TDD) (760) 777-1227 Dear Mr. Skinner: The Community Development Department has approved your request to establish a temporary office at 78 -186 -Avenida Buena Ventura, a rented house, .during construction of the Washington Street Bridge widening project, subjectto the following conditions: 1. If necessary, obtain a building permit. 2. Provide and maintain. restroom facilities to accommodate on-site construction workers; supervisors, and office personnel: 3. Mounted, on the exterior of the house close to the front door shall be a written notice providing emergency personnel your 24-hour emergency phone number'they can call in case problems arise that need your prompt attention (i.e., minimum 1" high letters). 4. Site address, visible from.the street for emergency personnel, shall be installed. 5. Install one 2AIOBC fire extinguisher inside.the home by the front exit door. 6. No temporary signs are permitted unless separately approved by this, Department, 7. 'Removal of the temporary use is required on March - 3, 2000, unless a time extension is applied for.and granted'by this Department. The Community Development Director may extend the permit for another six-month period if construction activities are still occurring. No fee is charged to extend this permit. 8.. Dust control measures shall be implemented to reduce and control blowing sand. 5 MUP 99-163 9. , .The City may elect to, add Conditions to this application request to mitigate any, problems that arise not previously addressed herein. Temporary landscaping is not. required to screen the activity if the site is kept clean and free of . construction related debris. This decision may be appealed to the Planning Commission provided the necessary paperwork and filing fee of $175.00 are filed, with this office. within 15 days. If you have any questions, please contact me at 760-777-7065. Sincerely; ; JERRY HERMAN COMMUNITY DEVELOPMENT DIRECTOR Fred Baker. AICP Principal Planner c: Community Development Director Building and Safety Director Sheriff's Department Code Compliance Department Fire Department Greg Butler, B/S Counter Technician MUP 99-163 Building Address Owner Mailing ' Address Sam City Zip Tel. L& Quinta 92253 Contractor C. V. Roofing Address state LIC. clty & Classif. Lic. # Arch., Engr., C-39, 35-2007 Designer Address I Tel. P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 CityI Zip I State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I a licensed under Prov et ins of Chapter 9 (commencing with §ection 7000) of ivis n 3 of Business.and Profesiohs Code, and my license is" i full force and effect. ! e , p - S GNATUR "' F 01-F OWNER• UILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). O I, as.owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year or completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professionvcode: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, andivho contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Lawly ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: It, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Ihereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above-. mentioned property for inspection purposes. Signature of applicant Date Mailing..Address City, State, Zip No. 08488 LDING: TYPE CONST. OCC: GRP. P. Number ,Legal Description Project Description Sq. Ft. Size No. Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑ RE fibF Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading;' Driveway'Enc. Infrastructure riA i A'?, AID A4 k'.."_ -30-90 -.. .. $4 JV. ILT43 IT U i "K A 9a .. TOTAL REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ 2ND FL. SQ. FT. POR. SO. FT. ® GAR. SQ, FT, ® CAR P. SQ. FT. WALL SO. FT. ® SQ FT ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN. URINAL WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM HEATING (FI ) KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. ® c BATH TUB BOND BEAM SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL LUMBER GR. SQ.FT.GAR ® V4c HOUSE SEWER FINAL IN ROOFING I GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEESMICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FI ) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. P GROUT WATER HEATER ERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. GRADING cu. yd. $ plus x$ =$ LUMBER GR. FRAMING FINAL IN ROOFING I REMARKS: VENTILATION FIRE ZONE ROOFING: FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION D s CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL CITY OF LA QUINTA i BUILDING & SAFETY DEPARTMENT i (760) 777-7012 INSPECTION. REQUEST LINE (760)_.777-7153 j it1` umL 404 aos jl O JOB IN CONSPICUOUS PLACE CTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 78-186 MAIN STREET DEMO TO BARE GROUND SINGLE FAMILY DWELLING, INCLUDING REMOVAL OF SEPTIC TYPE OF INSPECTION I DATE I INSP. TEMPORARY POWER SETBACKS U/G PLUMBING /WASTE U/G ELECTRICAL / GROUNDING FOOTINGS / STEEL CONCRETE SLAB DO NOT POUR CONCRETE UNTIL ABOVE SIGNED ROOF NAIL / PRE -ROOF OKAY TO WRAP FRAMING COMBINATION ROUGH ELECTRIC ROUGH PLUMBING ROUGH MECHANICAL INSULATION COVER NO WORK UNTIL ABOVE SIGNED INTERIOR GYP. BD. DRYWALL EXTERIOR LATH GAS TEST SEPTIC ABANDONMENT SEWER CONNECTION SEPTIC / GREASE INTERCEPTOR MASONRY INSPECTIONS FOOTINGS / STEEL BOND BEAM POOL / SPA / WATER FEATURE INSPECTIONS PRE-GUNITE / SETBACKS U/G PLUMBING U/G ELECTRICAL PRE -PLASTER (ALARMS / BARRIERS) DECK BONDING FINAL INSPECTIONS TEMP. USE OF PERMANENT POWER ELECTRICAL PLUMBING MECHANICAL PUBLIC WORKS DEPARTMENT COMMUNITY DEVELOPMENT DEPT. FINAL / JOB COMPLETED FJoll ABOVE APPROVALS DO NOT INCLUDE RIGHT TO TURN ON UTILITIES OR OCCUPY BUILDING